Pediatric Flexor Tendon Injuries
The diagnosis and management of pediatric flexor tendon injuries present unique challenges to the hand surgeon. Examination of young children is not always straightforward, and tendon lacerations are frequently diagnosed late ––sometimes weeks or months after the inciting injury. Four- and six-strand repair techniques are supported by recent literature, though the surgeon must remain diligent to ensure gliding of a bulky repair in a narrow tendon sheath. Beyond the operating room, postoperative management must be tai lored to accommodate nuances specific to patient age and behavioral development. A fluid, patient-speci...
Source: Hand Clinics - February 14, 2023 Category: Orthopaedics Authors: Brian W. Starr, Roger Cornwall Source Type: research
The Value of Diversity, Equity, and Inclusion
Patient race and ethnicity are important factors in health-care inequity, including care for the patient with hand and upper extremity pathologic condition. Physician diversity has been shown to promote better access, improve health-care quality, and improve satisfaction for underserved populations. Concordance, most often defined as a similarity or shared identity between physician and patient, has been shown to have a positive influence on health-care disparities. Although diversity among Hand surgeons is increasing, it is not matching the diversity of the population as a whole. It is imperative that we work to increase ...
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Christopher O. Bayne Source Type: research
Role of Health Equity Research and Policy for Diverse Populations Requiring Hand Surgery Care
Health equity requires allocation of resources to eliminate the systematic disparities in health, imposed on marginalized groups, which adversely impact outcomes. A socioecological approach is implemented to elucidate the role of health equity research and policy for underrepresented minority and socioeconomically disadvantaged populations. Through investigation of the individual, community, institution, and public policy, we investigate problems and propose solutions to ensure fair and just treatment of all patients requiring hand surgery. (Source: Hand Clinics)
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Paige L. Myers, Kevin C. Chung Source Type: research
Recruiting, Supporting and Retaining Diversity in Hand Surgery
All surgical fields that lead to a career in Hand Surgery have a stark lack of diversity of sex/gender and race, at every level of the workforce, from trainees to practicing physicians. Despite consistent statistics in publications on lack of diversity in surgical fields, a guide to effective recruitment and retention is lacking. Although we recognize that a strategy cannot be applied in all practices, this article provides actionable items to consider in the commitment and work toward a more just and equitable practice of Hand Surgery. (Source: Hand Clinics)
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Micah K. Sinclair, A. Bobby Chhabra Source Type: research
The Underrepresented Minority in Hand Surgery
Hand surgery is a subspecialty that requires additional fellowship training after a primary residency; a long and competitive journey to achieve success. An underrepresented in medicine (UIM) student ’s journey to becoming a hand surgeon in the United States adds another level of challenge given several defined obstacles. Despite the lack of representation, the chances of becoming a hand surgeon are difficult but not impossible. A comprehensive strategy for an UIM student to become a hand surg eon is outlined in detail. (Source: Hand Clinics)
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Marvin Dingle, Michael G. Galvez Source Type: research
LGBTQ+ Perspective in Hand Surgery
Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals and patients face high levels of discrimination both in the workplace and in the clinic setting, with more than 25% of LGBTQ+ people experiencing discrimination in the workplace due to their sexual orientation. Hand Surgery stands to continue to advance by encouraging the brightest st udents into the field no matter their background. LGBTQ+ patients also have specific needs within the field of Hand Surgery, where we are uniquely positioned to treat them or guide them by being well versed in the needs of the community. ...
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Joseph Paul Letzelter, Julie Balch Samora Source Type: research
The International Medical Graduate Perspective in Hand Surgery
International medical graduates (IMGs) have made significant contributions in the field of hand surgery in terms of bringing in skill, innovation, research, and leadership and have gone onto mentor the next generations of hand surgeons. In this article, we have highlights some such contributions. We also highlight various pathways that IMGs take to establish their practice in the United States and the various challenges and hurdles they face. (Source: Hand Clinics)
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Uzair Qazi, Laxminarayan Bhandari Source Type: research
Microaggressions and Implicit Bias in Hand Surgery
Implicit bias and microaggressions are well-known phenomenon and have recently been acknowledged as contributing to health care disparities. Within Hand Surgery, implicit bias and microaggressions occur in patient-surgeon, surgeon-peer, surgeon-staff, and training environment interactions. Although racial and gender biases are well studied, biases can also be based on age, sexual orientation, socioeconomic background, and/or hierarchal rank. Academia has well-documented evidence of implicit bias and microaggressions, contributing to current disparate demographics of trainees, physicians, and leaders within Hand Surgery. Aw...
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Kashyap Komarraju Tadisina, Kelly Bettina Currie Source Type: research
Allyship for Diversity, Equity, and Inclusion in Hand Surgery
This article endeavors to be a resource to those individuals interested in becoming an ally or educating potential allies in the field of Hand Surgery. The definitions of allyship, its history, and its expected benefits are considered. The qualities of a good ally are enumerated, and approaches to becoming a better ally are described. The authors provide personal experience with impactful allies and describe strategies and resources on a local and national level. The authors conclude with “Bigger Questions”: those issues that seem essential to have allyship succeed in expanding diversity, equity, and inclusion in the s...
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Shea Ray, Jennifer D ’Auria, Hannah Lee, Mark Baratz Source Type: research
Recruitment of the Next Generation of Diverse Hand Surgeons
This article outlines organizations, such as the Perry Initiative, which have increased recruitment of women and underrepresented minorities into pipeline programs. Techniques of minimizing bias and increasing opportunities for underrepresented groups are also discussed. (Source: Hand Clinics)
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Claire A. Donnelley, Andrea Halim, Lisa L. Lattanza Source Type: research
The Value of Diversity: Spectrum of Tissue, Training, and Individuals in Hand Surgery
“It falls to few men to originate a surgical specialty."— Sterling BunnellThe field of Hand Surgery was founded by Dr Sterling Bunnell, who was asked by the US Surgeon General, during World War II, to develop regional hand centers at Army Hospitals in the United States. The history of the foundi ng of Hand Surgery is important knowledge. The “few men” were the founders of the field and included only White men (Fig. 1). Dr Bunnell believed that Hand Surgery was a “composite problem requiring the correlation of the various specialties—Orthopaedic, Plastic and Neurologic Surgery—the knowledge of any one of whic...
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Michael G. Galvez, Kevin C. Chung Tags: Preface Source Type: research
Advocacy for Diversity in Hand Surgery
Diversity in the Hand Surgery workforce improves the quality of care delivered, advances a wider variety of innovation within the field and leads to higher patient satisfaction, greater access to care and patient adherence to advice. An understanding of the data makes a compelling argument for change. Advocacy is necessary to stop the “leaky pipeline” of the loss of diversity in more senior and leadership roles. Hand surgeons who are both women and from underrepresented minority groups are especially vulnerable to bias from the health-care system, with focused support and mentoring required throughout their training an...
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Angelo R. Dacus, Brittany Behar, Kia Washington Source Type: research
Inclusive Mentorship and Sponsorship
This article discusses the importance of and techniques for improving inclusive mentorship. (Source: Hand Clinics)
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Kamali Thompson, Erica Taylor Source Type: research
Women in Hand Surgery
Hand surgeons and trainees face many challenges in pursuit of their professional and familial goals. The culture of the training programs must change to aknowledge and address the needs of women as they naviagate career and their childbearing years. Challenges to maternity and family planning dissuade and perhaps prohibit female trainees from choosing surgical specialties and of those who do, from reaching their full professional potential. In the following chapter we will review current data on infertility, obstetrical complications, breastfeeding, maternity leave, career advancement and childcare in an effort to increase...
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Cathleen Cahill, Megan Conti Mica Source Type: research
Diverse Leadership in Hand Surgery
This article aims to define the term “success” and provide examples of how a diverse climate can lead to leadership success by highlighting a few stories of diverse giants in the field of Hand Surgery. (Source: Hand Clinics)
Source: Hand Clinics - November 17, 2022 Category: Orthopaedics Authors: Tiam M. Saffari, Maria T. Huayllani, Amy M. Moore Source Type: research
